Paschal Donohoe, the Minister for Public Expenditure, met with Health Minister Stephen Donnelly on Monday to discuss health sector costs, following a budget overrun of more than €500 million by the HSE in the initial quarter of the year. Additionally, the pay and staff strategy for the HSE – a blueprint for staffing number and types for the ongoing year, including salary budget allocation – is yet to be finalised.
Neither the Health Department nor the Public Expenditure Department issued a statement after the talks, which involved senior officials. The Health Minister is responsible for authorising the pay and staffing strategy compiled by the HSE, which hasn’t occurred. Ongoing discussions address the question of the more than 2,000 posts filled or promised by the HSE last year without the availability of sufficient funds.
Due to a lack of agreement on the staffing blueprint for the past months, HSE has predominantly avoided making staffing replacements, with Mr Donnelly admitting in the Dáil recently that the current hiring halt was a stop-gap measure. However, he is keen to resolve the issue as soon as possible in collaboration with the government.
Contrarily to the government’s claims of record funding for healthcare services, doctors will be arguing in front of the Oireachtas on Wednesday that the actual funding does not suffice for the needs of an expanding and ageing population. Susan Clyne, Irish Medical Organisation’s CEO, will argue to the Oireachtas Health Committee that the HSE’s seven-month recruitment freeze has forced non-consultant hospital doctors (NCHDs) into excessive working hours, jeopardising safe patient care. About 83% of NCHDs regularly work over 48 hours a week, which violates the Organisation of Working Time Act and breaches contractual rights.
Ms Clyne is set to highlight that 77% of Non-Consultant Hospital Doctors (NCHDs) are being coerced into working extra shifts to fulfil rota requirements, often with little to no prior notice. She will pinpoint how the narrative about unprecedented health budget levels and increasing employment in the healthcare sector obscures the true pressing demands facing the health services. This sector has suffered from a decade-long lack of sufficient funding, and despite being a public service that should prioritise value for money, the truth is that its funding does not currently match the needs of an ageing and growing population.
Ms Clyne will go on to mention that approximately 2,230 specialist doctors are currently practising under the recently introduced contract which caters solely to public patients, and which can potentially stretch their work hours throughout the day and week. Nevertheless, she will underscore that this new contractual approach cannot, on its own, rectify the long-standing issues faced by the health sector in terms of capacity and staffing needs.
She will stress that it is impractical to believe that making consultants work non-traditional hours will yield tangible benefits for the health sector. Due to the current staffing shortages, there is no room for flexibility – effectively, this approach equates to taking from one area to support another.